Pub Date : 2024-01-23DOI: 10.1097/io9.0000000000000008
Issaree Laopeamthong, Wisit Kasetsermwiriya, Suphakarn Techapongsatorn, A. Tansawet
Bariatric surgery is associated with sustainable weight loss and lower mortality. Presently, these procedures can be performed endoscopically. Among endoscopic procedures, endoscopic gastric plication (EGP) is the most studied but has not yet been compared among its variations. Studies were identified by searching database and reference lists. They would be eligible if they were conducted in adult patients with obesity, did not involve revision, compared EGP and controls, and reported at least 1-year weight loss results. The interventions of interest were endoscopic sleeve gastroplasty (ESG), primary obesity surgery endoluminal (POSE), and transoral gastroplasty (TOGA). The primary outcome was the percentage of excess weight loss (%EWL). From network meta-analysis, treatment comparisons between each intervention were estimated. The interventions were further ranked in terms of maximizing weight loss or minimizing severe adverse events (SAEs). Significant %EWLs from ESG and POSE versus control were observed at 12 months with pooled mean differences (MDs) and 95% CI of 44.7% (27.95%, 61.45%) and 16.29% (0.32%, 32.26%), respectively. The results also indicated that ESG was more efficacious than POSE [MD (95% CI): 28.41% (5.27%, 51.56%)] and TOGA [MD (95% CI): 36% (11.38%, 60.62%)]. For SAEs, ESG, POSE, and TOGA yielded relative risks (95% CI) of 2.81 (0.14, 56.85), 2.15 (0.13, 36.48), and 3.26 (0.07, 153.3), respectively, compared with the control. ESG was the best EGP, followed by POSE and TOGA. No significant increase in SAE was indicated from EGP. This network meta-analysis must be updated when more data are available.
{"title":"Endoscopic gastric plication: a network meta-analysis","authors":"Issaree Laopeamthong, Wisit Kasetsermwiriya, Suphakarn Techapongsatorn, A. Tansawet","doi":"10.1097/io9.0000000000000008","DOIUrl":"https://doi.org/10.1097/io9.0000000000000008","url":null,"abstract":"\u0000 \u0000 Bariatric surgery is associated with sustainable weight loss and lower mortality. Presently, these procedures can be performed endoscopically. Among endoscopic procedures, endoscopic gastric plication (EGP) is the most studied but has not yet been compared among its variations.\u0000 \u0000 \u0000 \u0000 Studies were identified by searching database and reference lists. They would be eligible if they were conducted in adult patients with obesity, did not involve revision, compared EGP and controls, and reported at least 1-year weight loss results. The interventions of interest were endoscopic sleeve gastroplasty (ESG), primary obesity surgery endoluminal (POSE), and transoral gastroplasty (TOGA). The primary outcome was the percentage of excess weight loss (%EWL). From network meta-analysis, treatment comparisons between each intervention were estimated. The interventions were further ranked in terms of maximizing weight loss or minimizing severe adverse events (SAEs).\u0000 \u0000 \u0000 \u0000 Significant %EWLs from ESG and POSE versus control were observed at 12 months with pooled mean differences (MDs) and 95% CI of 44.7% (27.95%, 61.45%) and 16.29% (0.32%, 32.26%), respectively. The results also indicated that ESG was more efficacious than POSE [MD (95% CI): 28.41% (5.27%, 51.56%)] and TOGA [MD (95% CI): 36% (11.38%, 60.62%)]. For SAEs, ESG, POSE, and TOGA yielded relative risks (95% CI) of 2.81 (0.14, 56.85), 2.15 (0.13, 36.48), and 3.26 (0.07, 153.3), respectively, compared with the control.\u0000 \u0000 \u0000 \u0000 ESG was the best EGP, followed by POSE and TOGA. No significant increase in SAE was indicated from EGP. This network meta-analysis must be updated when more data are available.\u0000","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140498219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-23DOI: 10.1097/io9.0000000000000006
Rapty Sarker, A. Roknuzzaman, M. Bhuiyan, Md. Rabiul Islam
{"title":"The upsurge of respiratory illnesses or pneumonia among children in Northern China: why is it hitting in China and is there any possibility to spread overseas?","authors":"Rapty Sarker, A. Roknuzzaman, M. Bhuiyan, Md. Rabiul Islam","doi":"10.1097/io9.0000000000000006","DOIUrl":"https://doi.org/10.1097/io9.0000000000000006","url":null,"abstract":"","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140498431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-23DOI: 10.1097/io9.0000000000000012
Zahra Ahmed, Shiban Ahmed
Conscious sedation has both a sedative and an analgesic effect. Ketamine is an increasingly popular choice for procedural conscious sedation in a paediatric day surgery. Ketamine is also cheaper than general anaesthetic. The objective of our study is to investigate the number of adverse events when using ketamine for procedural conscious sedation and demonstrate its safety profile for use in paediatric day surgery in a community setting in infants. A single-centre, single surgeon, single procedure 5-year longitudinal prospective review of 904 infants undergoing elective day-care surgery using ketamine for procedural conscious sedation between 2016 and 2020. Patients were stratified for pre-anaesthetic co-morbidities based on the American Society of Anesthesiologists (ASA) classification system. All patients were between 4 weeks and 1 year and 98.7% were ASA Class 1. Most children received ketamine intramuscularly and only one child required additional ketamine to maintain procedural conscious sedation. There were no serious adverse events and there were 27 mild adverse events in 26 patients (2.88% patients). The most common adverse event was hypersalivation, which occurred in 11 infants. Ketamine is a safe drug for procedural conscious sedation and should be considered more for infants undergoing elective day-care surgery provided that all staff conducting procedures have advanced training in paediatric and neonatal airway management and resuscitation.
{"title":"Demonstrating the safety profile of ketamine as procedural conscious sedation in infants; a prospective cohort study of 904 cases","authors":"Zahra Ahmed, Shiban Ahmed","doi":"10.1097/io9.0000000000000012","DOIUrl":"https://doi.org/10.1097/io9.0000000000000012","url":null,"abstract":"\u0000 \u0000 Conscious sedation has both a sedative and an analgesic effect. Ketamine is an increasingly popular choice for procedural conscious sedation in a paediatric day surgery. Ketamine is also cheaper than general anaesthetic. The objective of our study is to investigate the number of adverse events when using ketamine for procedural conscious sedation and demonstrate its safety profile for use in paediatric day surgery in a community setting in infants.\u0000 \u0000 \u0000 \u0000 A single-centre, single surgeon, single procedure 5-year longitudinal prospective review of 904 infants undergoing elective day-care surgery using ketamine for procedural conscious sedation between 2016 and 2020. Patients were stratified for pre-anaesthetic co-morbidities based on the American Society of Anesthesiologists (ASA) classification system.\u0000 \u0000 \u0000 \u0000 All patients were between 4 weeks and 1 year and 98.7% were ASA Class 1. Most children received ketamine intramuscularly and only one child required additional ketamine to maintain procedural conscious sedation. There were no serious adverse events and there were 27 mild adverse events in 26 patients (2.88% patients). The most common adverse event was hypersalivation, which occurred in 11 infants.\u0000 \u0000 \u0000 \u0000 Ketamine is a safe drug for procedural conscious sedation and should be considered more for infants undergoing elective day-care surgery provided that all staff conducting procedures have advanced training in paediatric and neonatal airway management and resuscitation.\u0000","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140498148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-19DOI: 10.1097/io9.0000000000000023
Mohammad Mirahmadi Eraghi, Sadegh Bagherzadeh, Alireza Khoshnevisan, Mohammad A. Habibi, Sadaf Sajedi Moghaddam, Milad Shafizadeh, Mohammadreza Firouzifar
Spontaneous cerebrospinal fluid (CSF) rhinorrhea without a history of head trauma is rare. The authors describe a scarce case of spontaneous, nontraumatic, delayed CSF rhinorrhea due to ethmoidal encephalocele associated with frontoparietal giant meningioma. A 49-year-old male complained of a slowly growing skull mass lasting 10 years since a blunt head trauma and progressive hemiparesis 3 months ago and was referred to our center. There was a heterogeneous extra-axial mass (77×77×70 mm) with calcified components at his right frontal lobe, demonstrating notable adjacent parenchymal edema and a midline shift to the left. There was a sizeable extra-axial mass (113×95×80 mm) in his right front-temporoparietal lobe associated with adjacent invasion to calvarium leading to the lytic and sclerotic appearance of the calvarial bone showing intense heterogeneous contrast enhancement and an adjacent enhancing dural tail. A considerable mass effect on the adjacent frontotemporal cortex is evident, with mild parenchymal edema leading to a notable midline shift to the left, right uncal herniation, and left ventriculomegaly. On postoperation day 5, the patient developed a recurrent CSF leak exacerbated by hydrocephalus. He was rescheduled to undergo endoscopic endonasal surgery and dural repair on postoperative day 7. The postoperative course was uneventful. Frontoparietal lobe encephaloceles represent the least common cause of spontaneous CSF rhinorrhea. Early diagnosis and surgical management remain crucial to minimize the subsequent complications. The ventricular anatomy and CSF fluid dynamics alteration following tumor surgical resection seem to contribute to an environment by which a herniated ethmoidal encephalocele developed a delayed nontraumatic CSF leak.
{"title":"Spontaneous delayed CSF rhinorrhea associated with encephalocele following surgical resection of a giant frontoparietal meningioma, an extremely rare entity and overlook of English literature","authors":"Mohammad Mirahmadi Eraghi, Sadegh Bagherzadeh, Alireza Khoshnevisan, Mohammad A. Habibi, Sadaf Sajedi Moghaddam, Milad Shafizadeh, Mohammadreza Firouzifar","doi":"10.1097/io9.0000000000000023","DOIUrl":"https://doi.org/10.1097/io9.0000000000000023","url":null,"abstract":"\u0000 \u0000 Spontaneous cerebrospinal fluid (CSF) rhinorrhea without a history of head trauma is rare. The authors describe a scarce case of spontaneous, nontraumatic, delayed CSF rhinorrhea due to ethmoidal encephalocele associated with frontoparietal giant meningioma.\u0000 \u0000 \u0000 \u0000 A 49-year-old male complained of a slowly growing skull mass lasting 10 years since a blunt head trauma and progressive hemiparesis 3 months ago and was referred to our center. There was a heterogeneous extra-axial mass (77×77×70 mm) with calcified components at his right frontal lobe, demonstrating notable adjacent parenchymal edema and a midline shift to the left. There was a sizeable extra-axial mass (113×95×80 mm) in his right front-temporoparietal lobe associated with adjacent invasion to calvarium leading to the lytic and sclerotic appearance of the calvarial bone showing intense heterogeneous contrast enhancement and an adjacent enhancing dural tail. A considerable mass effect on the adjacent frontotemporal cortex is evident, with mild parenchymal edema leading to a notable midline shift to the left, right uncal herniation, and left ventriculomegaly. On postoperation day 5, the patient developed a recurrent CSF leak exacerbated by hydrocephalus. He was rescheduled to undergo endoscopic endonasal surgery and dural repair on postoperative day 7. The postoperative course was uneventful.\u0000 \u0000 \u0000 \u0000 Frontoparietal lobe encephaloceles represent the least common cause of spontaneous CSF rhinorrhea. Early diagnosis and surgical management remain crucial to minimize the subsequent complications.\u0000 \u0000 \u0000 \u0000 The ventricular anatomy and CSF fluid dynamics alteration following tumor surgical resection seem to contribute to an environment by which a herniated ethmoidal encephalocele developed a delayed nontraumatic CSF leak.\u0000","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140502366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-19DOI: 10.1097/io9.0000000000000011
B. N. Ngam, Chinonso P. Shu, John Tharion, James A. Brown, Armia S.F. Kamel, C. G. Nwegbu
Congenital lobar emphysema (CLE) is a rare developmental lung anomaly that occasionally remains asymptomatic until adulthood. The right diagnosis is very crucial in its management. The authors report the case of a 29-year-old otherwise healthy, nonsmoker male. Referred after management of a presumptuous diagnosis of tension pneumothorax. His symptoms at initial presentation were a chronic cough and progressive exertional dyspnea. His chest radiography revealed absent lung markings in the right lung field with a trachea deviation to the left, interpreted as a tension pneumothorax. However, chest tube insertion worsened his dyspnea. A computed tomography scan, though initially interpreted as pneumothorax, showed findings consistent with CLE. Adult CLE is a very rare presentation. A computed tomography scan is the imaging of choice. Even though watchful waiting is reasonable in selected patients, lobectomy remains the standard of care, preferably via video-assisted thoracic surgery. Failure to recognize CLE or other cystic lung lesions can lead to harmful procedures.
{"title":"Congenital lobar emphysema mis-interpreted as tension pneumothorax: a case report and literature review","authors":"B. N. Ngam, Chinonso P. Shu, John Tharion, James A. Brown, Armia S.F. Kamel, C. G. Nwegbu","doi":"10.1097/io9.0000000000000011","DOIUrl":"https://doi.org/10.1097/io9.0000000000000011","url":null,"abstract":"\u0000 \u0000 Congenital lobar emphysema (CLE) is a rare developmental lung anomaly that occasionally remains asymptomatic until adulthood. The right diagnosis is very crucial in its management.\u0000 \u0000 \u0000 \u0000 The authors report the case of a 29-year-old otherwise healthy, nonsmoker male. Referred after management of a presumptuous diagnosis of tension pneumothorax. His symptoms at initial presentation were a chronic cough and progressive exertional dyspnea. His chest radiography revealed absent lung markings in the right lung field with a trachea deviation to the left, interpreted as a tension pneumothorax. However, chest tube insertion worsened his dyspnea. A computed tomography scan, though initially interpreted as pneumothorax, showed findings consistent with CLE.\u0000 \u0000 \u0000 \u0000 Adult CLE is a very rare presentation. A computed tomography scan is the imaging of choice. Even though watchful waiting is reasonable in selected patients, lobectomy remains the standard of care, preferably via video-assisted thoracic surgery.\u0000 \u0000 \u0000 \u0000 Failure to recognize CLE or other cystic lung lesions can lead to harmful procedures.\u0000","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140503074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-19DOI: 10.1097/io9.0000000000000004
Moatasem Hussein Al-janabi, Hala Ashkar, Deema Zainab, Marah Ghanem Mohammad, Raghad Eid, Hikmat Yakoub, Z. Al-shehabi
A congenital granular cell tumor is an uncommon benign soft tissue tumor in newborns. It occurs mostly as a single tumor, that mainly affects the oral mucosa, especially the maxillary alveolar ridge. The tumor has a female predilection, with the female-to-male ratio being 10:1. A congenital granular cell tumor is believed to be of mesenchymal origin, and its exact etiology remains unclear. In this report, the authors present a case of a congenital granular cell tumor on the maxillary alveolar ridge in a 20-day-old female infant. Due to difficulty with breast-feeding, the surgical excision was performed under general anesthesia, and the intraoral mass was completely resected. A histopathological examination of the specimen led to the diagnosis of a congenital granular cell tumor. The congenital gingival granular cell tumor of the newborn is a rare benign tumor. Congenital gingival granular cell tumors are believed to be of mesenchymal origin, and their exact etiology remains unclear. These tumors are usually solitary and present as asymptomatic, firm, mobile, and subcutaneous masses. It is reported that these tumors are found three times more frequently in the maxillary anterior region than in the mandibular region. A congenital granular cell tumor is a rare benign lesion that is found exclusively in newborn infants. The clinical appearance of congenital granular cell tumors may be variable, making it difficult to distinguish them from other tumors. However, histopathological examination is the gold standard for diagnosis. Surgical excision is the most common and effective treatment option, with no recurrence rates.
{"title":"Congenital granular cell tumor of a newborn: a case report of a rare entity","authors":"Moatasem Hussein Al-janabi, Hala Ashkar, Deema Zainab, Marah Ghanem Mohammad, Raghad Eid, Hikmat Yakoub, Z. Al-shehabi","doi":"10.1097/io9.0000000000000004","DOIUrl":"https://doi.org/10.1097/io9.0000000000000004","url":null,"abstract":"\u0000 \u0000 A congenital granular cell tumor is an uncommon benign soft tissue tumor in newborns. It occurs mostly as a single tumor, that mainly affects the oral mucosa, especially the maxillary alveolar ridge. The tumor has a female predilection, with the female-to-male ratio being 10:1. A congenital granular cell tumor is believed to be of mesenchymal origin, and its exact etiology remains unclear.\u0000 \u0000 \u0000 \u0000 In this report, the authors present a case of a congenital granular cell tumor on the maxillary alveolar ridge in a 20-day-old female infant. Due to difficulty with breast-feeding, the surgical excision was performed under general anesthesia, and the intraoral mass was completely resected. A histopathological examination of the specimen led to the diagnosis of a congenital granular cell tumor.\u0000 \u0000 \u0000 \u0000 The congenital gingival granular cell tumor of the newborn is a rare benign tumor. Congenital gingival granular cell tumors are believed to be of mesenchymal origin, and their exact etiology remains unclear. These tumors are usually solitary and present as asymptomatic, firm, mobile, and subcutaneous masses. It is reported that these tumors are found three times more frequently in the maxillary anterior region than in the mandibular region.\u0000 \u0000 \u0000 \u0000 A congenital granular cell tumor is a rare benign lesion that is found exclusively in newborn infants. The clinical appearance of congenital granular cell tumors may be variable, making it difficult to distinguish them from other tumors. However, histopathological examination is the gold standard for diagnosis. Surgical excision is the most common and effective treatment option, with no recurrence rates.\u0000","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140503098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-19DOI: 10.1097/io9.0000000000000001
Md. Masuk-Ur-Rahman Shoukhin, Ramisa Anjum, S. M. R. Dewan
{"title":"Epidemiological challenges and opportunities: strengthening healthcare resilience against flurona in low-income and middle-income countries","authors":"Md. Masuk-Ur-Rahman Shoukhin, Ramisa Anjum, S. M. R. Dewan","doi":"10.1097/io9.0000000000000001","DOIUrl":"https://doi.org/10.1097/io9.0000000000000001","url":null,"abstract":"","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140503205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-19DOI: 10.1097/io9.0000000000000015
D. O. Otieno, Ruth W. Njoroge, Josiah Moki, A. Okello, Mohamed Dahir
Interestingly, the current shift in mastectomy patterns and advances in reconstruction techniques have contributed to an increasing number of patients requesting breast reconstruction postmastectomy every year. Depending on available expertise, patients can access breast reconstruction options (immediate or delayed), autologous, or implant-based. We present a case of a 36-year-old female patient 5 years into remission, having undergone mastectomy for invasive ductal carcinoma of the right breast and now preferred risk reduction surgery (prophylactic mastectomy) of her left unaffected breast with immediate reconstruction. The microsurgical technique utilized bilateral profunda artery perforator flaps from both thighs for (immediate and delayed) breast reconstruction. In our scenario, the authors had an unfavorable outcome on the side of delayed breast reconstruction (right) with a venous insufficiency diagnosis leading to unilateral complete flap loss, which was subsequently debrided and reconstructed with an obliquely-oriented pedicled Latissimus dorsi flap. In contrast, following risk reduction surgery and immediate reconstruction on the left side, the buried flap was a complete success, with the free nipple graft doing well postoperatively.
{"title":"Complex breast reconstruction using bilateral profunda artery perforator-free-flaps in a resource-limited setting: a case report","authors":"D. O. Otieno, Ruth W. Njoroge, Josiah Moki, A. Okello, Mohamed Dahir","doi":"10.1097/io9.0000000000000015","DOIUrl":"https://doi.org/10.1097/io9.0000000000000015","url":null,"abstract":"Interestingly, the current shift in mastectomy patterns and advances in reconstruction techniques have contributed to an increasing number of patients requesting breast reconstruction postmastectomy every year. Depending on available expertise, patients can access breast reconstruction options (immediate or delayed), autologous, or implant-based. We present a case of a 36-year-old female patient 5 years into remission, having undergone mastectomy for invasive ductal carcinoma of the right breast and now preferred risk reduction surgery (prophylactic mastectomy) of her left unaffected breast with immediate reconstruction. The microsurgical technique utilized bilateral profunda artery perforator flaps from both thighs for (immediate and delayed) breast reconstruction. In our scenario, the authors had an unfavorable outcome on the side of delayed breast reconstruction (right) with a venous insufficiency diagnosis leading to unilateral complete flap loss, which was subsequently debrided and reconstructed with an obliquely-oriented pedicled Latissimus dorsi flap. In contrast, following risk reduction surgery and immediate reconstruction on the left side, the buried flap was a complete success, with the free nipple graft doing well postoperatively.","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140502437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-19DOI: 10.1097/io9.0000000000000021
Eniyew A. Alemu, H. Tawuye, Y. A. Ferede, D. Y. Fentie
Pain management is a challenging intervention for children of all ages and a major worldwide health issue for painful illnesses that are stressful and range from moderate to severe. Inadequate pain management has serious short-term and long-term consequences for the physical, psychological, social, and physiological well-being of infants, toddlers, preschoolers, and schoolchildren. This study set out to assess nurses’ behaviours in treating paediatric pain and associated factors. A multicenter cross-sectional study was conducted. Convenient sampling was used to pick each participant in this study. The information was gathered using self-administered, semi-structured, and structured questionnaires. In the multivariable logistic regression analysis, variables with a P-value of 0.05 or less were considered statistically significant for the outcome variable. The adjusted odds ratio (AOR) and crude odds ratio with the appropriate 95% CI were computed to determine the strength of the link between the dependent and independent variables. A total of 356 nurses were invited to participate in this study, with a response rate of 314 (88.2%) (95% CI: 53.3–64.4) in the study of participant nurses. It was found that level of education, having a master’s degree (AOR=6.35, CI=1.03–38.23), a child’s cooperativeness for taking pain medication (AOR=2.11, CI=1.25–3.55), the presence of an evidence-based protocol for paediatric pain management in the facility (AOR=1.75, CI=1.007–3.03), work experience in the nursing profession for more than 2 years (AOR=1,97, CI=0.71–4.31), and the availability of a paediatric pain assessment tool also, had three times more engaged in good paediatric pain management practice 2.96 (AOR=2.96 (CI: 1.66–5.28)) and having training on pain management (AOR=2.64, CI=1.27–5.47) were associated with paediatric pain management practice. Most of the participants were proficient at handling pain in children. The majority of participants had good practices, but there are still several crucial traits that have a big influence on how nurses manage paediatric pain. As a result, the authors suggest offering easily accessible paediatric pain assessment instruments, evidence-based procedures, and paediatric pain treatment in-service training.
{"title":"Paediatrics pain management practice and associated factor among nurses at comprehensive and specialized hospital, Northwest Ethiopia, 2023: hospital based multicentre cross-sectional study","authors":"Eniyew A. Alemu, H. Tawuye, Y. A. Ferede, D. Y. Fentie","doi":"10.1097/io9.0000000000000021","DOIUrl":"https://doi.org/10.1097/io9.0000000000000021","url":null,"abstract":"\u0000 \u0000 Pain management is a challenging intervention for children of all ages and a major worldwide health issue for painful illnesses that are stressful and range from moderate to severe. Inadequate pain management has serious short-term and long-term consequences for the physical, psychological, social, and physiological well-being of infants, toddlers, preschoolers, and schoolchildren. This study set out to assess nurses’ behaviours in treating paediatric pain and associated factors.\u0000 \u0000 \u0000 \u0000 A multicenter cross-sectional study was conducted. Convenient sampling was used to pick each participant in this study. The information was gathered using self-administered, semi-structured, and structured questionnaires. In the multivariable logistic regression analysis, variables with a P-value of 0.05 or less were considered statistically significant for the outcome variable. The adjusted odds ratio (AOR) and crude odds ratio with the appropriate 95% CI were computed to determine the strength of the link between the dependent and independent variables.\u0000 \u0000 \u0000 \u0000 A total of 356 nurses were invited to participate in this study, with a response rate of 314 (88.2%) (95% CI: 53.3–64.4) in the study of participant nurses. It was found that level of education, having a master’s degree (AOR=6.35, CI=1.03–38.23), a child’s cooperativeness for taking pain medication (AOR=2.11, CI=1.25–3.55), the presence of an evidence-based protocol for paediatric pain management in the facility (AOR=1.75, CI=1.007–3.03), work experience in the nursing profession for more than 2 years (AOR=1,97, CI=0.71–4.31), and the availability of a paediatric pain assessment tool also, had three times more engaged in good paediatric pain management practice 2.96 (AOR=2.96 (CI: 1.66–5.28)) and having training on pain management (AOR=2.64, CI=1.27–5.47) were associated with paediatric pain management practice.\u0000 \u0000 \u0000 \u0000 Most of the participants were proficient at handling pain in children. The majority of participants had good practices, but there are still several crucial traits that have a big influence on how nurses manage paediatric pain. As a result, the authors suggest offering easily accessible paediatric pain assessment instruments, evidence-based procedures, and paediatric pain treatment in-service training.\u0000","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140502447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-19DOI: 10.1097/io9.0000000000000020
Dheker M. Touati, Fahd Khefacha, M. R. Ben Othmane, Nadhem Khlifi, Firas Jaouad, Marwa Idani, A. Belhadj, A. Saidani, Faouzi Chebbi
Echinococcosis, also known as a hydatid cyst, arises from a parasitic infection caused by the larval form of the tapeworm Echinococcus granulosus in humans. This endemic disease in Tunisia presents a significant public health challenge. The case highlights the enormous size of the liver hydatid cyst, emphasizing the importance and success of conservative surgical treatment. A 45-year-old female shepherdess presented with abdominal pain and a mass, diagnosed as a giant hepatic hydatid cyst. A computed tomography scan revealed a dysmorphic liver with a large multivesicular cyst. Surgical intervention included the resection and closure of multiple cystic fistulas. Postoperative recovery was uneventful and at the 6-month follow-up, the patient displayed no indications of recurrence. Echinococcosis, prevalent in livestock-farming regions, primarily affects the liver and lungs. It often remains asymptomatic, detected incidentally. Diagnosis relies on imaging, with surgical excision as the primary treatment. Percutaneous options exist but are less effective. Serologies are underused. Management challenges include complications and recurrence. Conservative surgery is common but faces complications. Radical surgery is more effective, albeit complex. Albendazole preoperatively proves promising, reducing cyst viability. Regular follow-up is crucial for recurrence detection. Managing giant hepatic hydatid cysts requires tailored approaches, especially in endemic regions. Our success with conservative surgical treatment highlights its effectiveness in confronting formidable cyst sizes, informing clinical practice, and contributing to the medical literature.
{"title":"Success in managing a giant hepatic hydatid cyst: a case report of successful conservative surgical intervention in an endemic setting","authors":"Dheker M. Touati, Fahd Khefacha, M. R. Ben Othmane, Nadhem Khlifi, Firas Jaouad, Marwa Idani, A. Belhadj, A. Saidani, Faouzi Chebbi","doi":"10.1097/io9.0000000000000020","DOIUrl":"https://doi.org/10.1097/io9.0000000000000020","url":null,"abstract":"\u0000 \u0000 Echinococcosis, also known as a hydatid cyst, arises from a parasitic infection caused by the larval form of the tapeworm Echinococcus granulosus in humans. This endemic disease in Tunisia presents a significant public health challenge. The case highlights the enormous size of the liver hydatid cyst, emphasizing the importance and success of conservative surgical treatment.\u0000 \u0000 \u0000 \u0000 A 45-year-old female shepherdess presented with abdominal pain and a mass, diagnosed as a giant hepatic hydatid cyst. A computed tomography scan revealed a dysmorphic liver with a large multivesicular cyst. Surgical intervention included the resection and closure of multiple cystic fistulas. Postoperative recovery was uneventful and at the 6-month follow-up, the patient displayed no indications of recurrence.\u0000 \u0000 \u0000 \u0000 Echinococcosis, prevalent in livestock-farming regions, primarily affects the liver and lungs. It often remains asymptomatic, detected incidentally. Diagnosis relies on imaging, with surgical excision as the primary treatment. Percutaneous options exist but are less effective. Serologies are underused. Management challenges include complications and recurrence. Conservative surgery is common but faces complications. Radical surgery is more effective, albeit complex. Albendazole preoperatively proves promising, reducing cyst viability. Regular follow-up is crucial for recurrence detection.\u0000 \u0000 \u0000 \u0000 Managing giant hepatic hydatid cysts requires tailored approaches, especially in endemic regions. Our success with conservative surgical treatment highlights its effectiveness in confronting formidable cyst sizes, informing clinical practice, and contributing to the medical literature.\u0000","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140503088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：